Abstract
BackgroundPrevious studies have demonstrated that appropriate treatment for postoperative pain can lead to improvement in depressive symptoms, however the association between adequate intrapartum pain control and the development of postpartum depression is not clear. The purpose of the study was to examine the effects of labor epidural analgesia and postpartum depression.MethodsWe performed a quantitative systematic review in compliance with the PRISMA statement. We conducted a search of PubMed, Embase, the Cochrane Database of Systematic Reviews and Google Scholar databases. The primary outcome was a positive screen of postpartum depression among women who received labor epidural analgesia up to 3 months into the postpartum period. Meta-analysis was performed using the random effect model.ResultsOf the 148 studies available, 9 studies with 4442 patients were included in the analysis. The use of labor analgesia on positive depression screen compared to control revealed no significant effect, OR (95% CI) of 1.02 (0.62 to 1.66, P = 0.94).ConclusionBased on current literature, the use of epidural analgesia for pain relief during labor doesn’t appear to affect the likelihood of postpartum depression. Future studies are warranted to further investigate these findings and identity other possible preventative interventions that reduce postpartum depression.
Highlights
Previous studies have demonstrated that appropriate treatment for postoperative pain can lead to improvement in depressive symptoms, the association between adequate intrapartum pain control and the development of postpartum depression is not clear
The main objective of the current study is to evaluate a possible association between optimal labor analgesia using epidurals and the development of postpartum depression
It is possible that the acute nature of labor pain is not enough to lead to the development of postpartum depression
Summary
Previous studies have demonstrated that appropriate treatment for postoperative pain can lead to improvement in depressive symptoms, the association between adequate intrapartum pain control and the development of postpartum depression is not clear. The purpose of the study was to examine the effects of labor epidural analgesia and postpartum depression. Pain is a well-known risk factor for the development of depression [6]. The inclusion of peripartum pain as a potential risk factor for the development of postpartum depression has only recently been identified and more extensively studied [7]. Several studies have evaluated the association between the use of labor epidurals and postpartum depression leading to conflicting results. It is currently unknown if optimal peripartum pain control using epidural analgesia is associated with a reduction in the incidence of postpartum depression
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